TÜRKİYE’DE ANTİBİYOTİK TÜKETİM MİKTARININ VE BİRİNCİ BASAMAK SAĞLIK HİZMETLERİNDE ANTİBİYOTİK REÇETELEME UYGULAMALARININ OECD ÜLKELERİ İLE KARŞILAŞTIRMALI OLARAK DEĞERLENDİRİLMESİ

Bu çalışmanın amacıTürkiye’de antibiyotik tüketim miktarının ve antibiyotik reçeteleme uygulamalarının Ekonomik Kalkınma ve İşbirliği Örgütü (OECD) ülkeleri ile karşılaştırmalı olarak değerlendirilmesidir. Bu çalışma, OECD Sağlık Verileri ve Dünya Sağlık Örgütü (DSÖ) Avrupa Antimikrobiyal İlaçlar Tüketim Ağı veritabanları üzerinden Türkiye ve OECD ülkelerindeki antibiyotik tüketim ve reçeteleme verisinin karşılaştırmalı analizidir. Antibiyotik tüketim hacmi, DID (her 1000 kişi için tanımlanmış günlük doz)olarak verilmiştir. Türkiye’nin 2013’de 41.1 DID olan toplam sistemik antibakteriyel ilaç tüketim hacmi, 2017 ve 2018 yıllarında sırasıyla 35.5 DID ve 31.0 DID düzeyine düşmüştür. Türkiye OECD ülkeleri arasında, 2013’de en yüksek antibiyotik tüketimine sahipken, 2018’de bu tüketimde %24.6’lık bir düşüş göstermiştir. DSÖ veritabanında Türkiye’de beta-laktam grubu antibiyotiklerin kullanım oranı 2013-2017 yılları arasında %43.9’dan %47’ye çıkarken, sefalosporinlerin kullanım oranı %32.1’den %26.4’e düşmüştür. Türkiye’de tüketilen toplam antibiyotik miktarının sadece %41.3’ünün birinci basamak sağlık hizmetlerinde reçetelenmektedir, bu değer tüm OECD ülkeleri arasındaki en düşük orandır. Sonuç olarak, Türkiye OECD ülkeleri arasında hala en yüksek antibiyotik tüketim miktarına sahip ülkeler arasındadır. Ancak, özellikle 2016 yılından itibaren Türkiye’de antibiyotik tüketim miktarında belirgin düşüş olması ve “birinci sıra” antibiyotikler tüketiminde artışla birlikte “ikinci sıra” antibiyotiklerin tüketiminde azalma olması dikkat çekicidir. Bu olumlu ve umut verici bulguların, ulusal düzeyde alınan tedbirlerin sonucu olduğu düşünülmektedir.

Anahtar Kelimeler:

Anti-bakteriyel ajanlar, bakteriyel direnç, birinci basamak sağlık hizmetleri, OECD, Türkiye

EVALUATION OF ANTIBIOTIC CONSUMPTION OF POPULATION AND ANTIBIOTIC PRESCRIBING PRACTICES IN PRIMARY HEALTH CARE SERVICES IN TURKEY IN COMPARISON TO OECD COUNTRIES

In this study, we aimed to evaluatethe antibiotic consumption in population and antibiotic prescribing practices in primary healthcare in Turkey in comparison to the OECD countries.This is a database analysis on the OECD Health Data and WHO European Network of Antimicrobial Drugs Consumption database. Antibiotic consumption volume was given as DID (daily dose defined per 1000 people). Total antibiotic consumption in Turkey was 41.1 DID in 2013, which decreased to 35.5 DID and 31.0 DID in 2017 and 2018, respectively. Among OECD countries, Turkey had the highest antibioticconsumption in 2013, which showed a 24.6% decrease in 2018. Consumption of beta-lactam antibiotics in Turkey increased from 43.9% to 47% between 2013 and 2017, while that of cephalosporin decreased from 32.1% to 26.4%. Only 41.3% of antibiotics consumed in Turkey are prescribed in primary health care services, which is the lowest among OECD countries. In conclusion, Turkey is still among the countries with the highest antibiotic consumption in OECD. However, there is a significant decrease in antibiotic consumption in Turkey since 2016, along with an increase in the consumption of "first-line" antibioticsand a decrease in consumption of "second-line" antibiotics. These promising findings might be the result of measures taken at national level.

Keywords:

Anti-bacterial agents drug resistance, bacterial, OECD, primary health care, Turkey,

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